A 70-year-old patient with long-standing type 2 diabetes mellitus presents with complaints of pain in the left ear with purulent drainage. On physical examination, the patient is afebrile. T he pinna of the left ear is tender, and the external auditory canal is swollen and edematous. T he white blood cell count is normal. Which of the following organisms is most likely to grow from the purulent drainage?

A 48-year-old black female complains of joint pain and morning stiffness over 4 months. Examination reveals swelling of the wrists and MCPs as well as tenderness and joint effusion in both knees. The rheumatoid factor is positive, antibodies to cyclic citrullinated protein are present, and subcutaneous nodules are noted on the extensor surfaces of the forearm.Which of the following statements is correct?

a. Prednisone 60 mg per day should be startedb. The patient has RA and should be evaluated for disease-modifying antirheumatic therapyc. A nonsteroidal anti-inflammatory drug should be added to aspirind. The patient’s prognosis is highly favorablee. The patient should receive a 3-month trial of full-dose nonsteroidal antiinflammatory agent before determining whether and/or what additional therapy is indicated.

A 40-year-old female complains of 7 weeks of pain and swelling in both wrists and knees. The patient complained of fatigue and lethargy several weeks before noticing the joint pain. The patient notes that after a period of rest, resistance to movement is more striking. On exam, the metacarpophalangeal joints and wrists are warm and tender. There are no other joint abnormalities. There is no alopecia, photosensitivity, kidney disease, or rash. Which of the following is correct?a. The clinical picture suggests early rheumatoid arthritis, and a rheumatoid factor should be obtainedb. The prodrome of lethargy suggests chronic fatigue syndromec. Lack of systemic symptoms suggests osteoarthritisd. X-rays of the hand are likely to show joint space narrowing and erosione. An aggressive search for occult malignancy is indicated

A 30-year-old male patient complains of fever and sore throat for several days. The patient presents to you today with additional complaints of hoarseness, difficulty breathing, and drooling. On examination, the patient is febrile and has inspiratory stridor. Which of the following is the best course of action?